The New You with Tanya Loots

Restoration of the nipple and areola (the ring of pigmented skin around the nipple) are an integral part of the reconstructive process. Restorative mastectomy tattooing – also known as dermapigmentation or paramedical tattooing – is the final procedure in this process.

Various surgical procedures are available for the reconstruction of both the nipple and areola; thereafter the pigmentation of this area of the skin renders realistic-looking areolas and nipples, as well as reducing the appearance of scars.

Although the nipple and areola are formed structurally, they still lack the distinguishing characteristics of a natural nipple and areola. This is where dermapigmentation comes into its own. Skin grafting was mostly used in the past to construct the areola; reconstructive areola tattooing has made this procedure unnecessary as the areola is now built-up around the reconstructed nipple, solely by tattooing.

Although most people have the nipple-areola reconstructed through surgery, many choose not to have any more surgery done once the breast mound is successfully reconstructed.   For these people, 3-D nipple-areola simulation presents an ideal alternative. This procedure creates the illusion of a protruding nipple. To simulate three dimensional form, tonal variations, contrast and shading techniques are effectively used to create the illusion of depth.

What exactly is dermapigmentation? 

It is the method of depositing hypo-allergenic mineral pigment into the dermal layer of the skin by use of a micro-thin needle.

Special knowledge and proper training is required to be able to safely tattoo skin that has been radiated and/or stretched. The process consists of at least two visits, depending on each particular case. The initial visit includes the consultation and initial saturation procedure, then a follow-up visit or more if needed.

Photographs, which are sent to me before the consultation visit, are used to make preliminary drawings, and plan the procedure. During the initial procedure, precise measurements are taken to determine the basic structure, colour, and placement of the areola.

Once the patient is satisfied with the choice of colour and placement, a numbing cream is applied to the areas needing to be worked on, and the magic begins.

A small device holding the micro-needle injects the pigment into the dermal layer of the skin. The most advanced pigments are used to mimic the skin colour with absolute safety. The procedure itself takes about 45 minutes per side.

The procedure is performed at a medical facility in a sterile environment. Only state of the art medical equipment is used to ensure the patient’s comfort, safety, and best results possible.

An aftercare kit is provided to each patient. The kit includes medical grade supplies and detailed instructions. Aftercare comprises mainly of keeping the area clean, avoiding direct sunlight, taking care not to wet the area, and preventing it from drying out. Aftercare achieves the best healed results.

Follow-up sessions occur four to six weeks after the initial saturation procedure. Some patients who have had unilateral reconstruction may need to have both areolas worked on to achieve symmetry. This may call for a bilateral session or two. Unfortunately, medical aid schemes don’t cover these procedures.

The cost for the initial areola restoration restoration saturation procedure ranges from R1 900 to R3 900, depending if you’re having unilateral or bilateral, and the 3-D nipple areola procedure ranges from R2 300 to R4 600, also dependent on unilateral or bilateral. There is also a cost for follow-up procedures. Please note prices may vary at different establishments.

A 3-D nipple areola simulation is done on clients who didn’t have a nipple surgically created. In these cases, an illusion of a protruding nipple is created with tattooing. The same technique is used to create more definition on reconstructed nipples as well.


Tanya Loots is a qualified dermapigmentologist. At present, she is the only paramedical tattooist in SA who specialises exclusively in nipple and areola repigmentation for breast cancer patients. Her own journey with breast cancer has equipped her for what she considers her calling. Visit or call 072 833 6938.